Global drug prices

Editor, – According to Professor Ron Penny, there is an unbelievable array of effective medicines that have reduced the number of HIV/AIDS related deaths in Australia from 2790 in 1992 to 97 in 2001.

The World Health Organization (WHO) has categorically stated that access to innovative medicines and vaccines has been substantially the most important factor in achieving the dramatic decline in mortality rates throughout the twentieth century.¹

These statements contrast starkly with the opinion of Dr Moran who hypothesised in her recent editorial ('Why are global drug prices so high... and other questions' Aust Prescr 2003;26:26-7)that the interests of the prescription medicines industry lie in 'maximising profits and growth, not in identifying and filling health needs'.

There are many industry driven programs that treat disease and alleviate suffering in resource poor countries. One of the most successful partnerships is the Accelerating Access Initiative program that includes UNAIDS (Joint United Nations Programme on HIV/AIDS), WHO, the World Bank and pharmaceutical companies. This currently has 27 000 people on antiretroviral therapy throughout the world.²

Dr Moran suggested that the medicines industry targets 'money-spinner drugs and diseases'. This ignores the critical fact that in Australia these diseases are precisely the diseases that are the focus of the seven National Health Priorities (asthma, cancer, cardiovascularhealth, diabetes, injuryprevention, mental health and arthritis)established not by the medicines industry but by Australian Health Ministers.

Innovative cures to treat disease only come from the research-based medicines industry because governments and even venture capitalists are not prepared to invest in such a high-risk venture. Latest research estimates that it costs about $1.1 billion³ to bring a new medicine from discovery to patient - along a 12-15 year journey.

This vitally important commitment of the medicines industry is ignored by Dr Moran.

Kieran Schneemann

Chief Executive

Medicines Australia

Canberra

Dr M. Moran, author of the article, comments:

I absolutely agree that the pharmaceutical industry develops useful, new drugs. My point is that they only do so when these new drugs are also likely to deliver substantial profits, thereby effectively restricting new drug development to common diseases of Western consumers.

I am not criticising industry for seeking profitable research investments nor suggesting that they stop doing so - this is unrealistic. What I am saying is that profit-seeking firms should not be in charge of setting global drug research agendas, since the vast bulk of the world lies outside their sphere of economic interest. An alternative model is needed: for instance, an international research and development convention to define research needs and establish mechanisms to fund these.

I disagree that 'innovative cures only come from the research-based medicines industry because governments are not prepared to invest in such a high risk venture'. This is not true. Half of the US$70 billion invested in drug research each year comes from the public sector, chiefly as funding for basic research, which is the highest risk part of the drug development pipeline.⁴ Ten AIDS drugs were fully developed or supported by publicly funded research⁵,and the US Government supported the clinical research for 34 of the 37 new cancer drugs marketed in the USA since 1955.6

The time for pointing the finger or seeking public relations wins is over. We must accept that our current system is not delivering the drugs the world needs and start working together to solve this problem.